Real Lives Pt.5

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From TPM Reader GF

In a recent letter from a reader he noted:

“My premium, for a plan fairly equivalent to “gold” level on the exchanges is increasing by $1.59 per month…”

I’ve been self-employed since about mid-1997 and live in Seattle. Washington State has had very powerful insurance commissioners, so much so that a bunch of carriers left the state briefly in the late 1990s until the state and they could rejigger some of the actuarial stuff. As a result, when I compare my premiums and benefits to people in other states, I’m generally pretty happy. I suspect Washington’s overall average healthcare costs remain lower than elsewhere, too. Seattle’s big “chain” is a non-profit that has highly compensated executives but it is, nonetheless, pretty great.

I had a non-ACA compliant plan in 2012 that was expensive (covering myself, my wife, and our two kids; she is a homemaker, so I can deduct the cost of insurance). It had a $0 deductible and a high out-of-pocket limit, and we’d had it for a few years. It had risen to $1200 a month by 2012. We got a notice it was going to jump to $1800 per month in 2013! But a comparable plan with a $2000 per person deductible and some other better benefits was just $800 per month. We did fine with that. We are modest users of healthcare, and I had a heart intervention this year. We’re paying quite a bit, but the plan covered everything and I hit my out of pocket limit, and there have been no hassles. Our costs have been contained.

We looked at 2014 plans, and the gold level will be about $1100 per month — seemingly much higher, right? But the deductible changes. In 2013, we had $2,000 per person deductibles. In 2014 with “gold,” it’s $1,000 per person and $2,000 per family before co-insurance kicks in.

In 2014, we get a prescription plan, absent from 2011 to 2013 in our plans. We get pediatric vision and dental. There are other minor improvements as well.

So I wonder when someone says a non-compliant 2013 and a compliant 2014 plan are similar if they drill down that far (or have children).

For us, with a variety of modest, treatable chronic conditions that would be cheap to deal with in Europe (cheap in terms of what a provider would bill there), we might save $3,000 to $6,000 over our 2013 costs.

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Josh Marshall is editor and publisher of TalkingPointsMemo.com.
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